In the proposed study, the applicant will assess the impact of Medical Imaging Informatics (MII) on healthcare costs and quality. The overall goal is to develop a "business case for quality" related to MII utilization. MII systems have the potential to improve the safety and quality of care by enhancing effectiveness, timeliness and efficiency, yet fewer than 15 percent of hospital radiology departments have fully implemented them. The low percentage of radiology departments with fully implemented MII systems represents an opportunity to improve the quality and safety of patient care. However, the decision to deploy a comprehensive MII system is often based on financial considerations, rather than the potential to improve quality and safety. A better understanding of the financial and operational value of MII systems will facilitate decision-making regarding MII deployment and result in substantial improvements in healthcare quality and safety. This project will evaluate MII deployment at Massachusetts General Hospital (MGH) and at New York University (NYU). The opportunity to study MII deployment at two large academic medical centers that underwent the process almost a decade apart presents a unique opportunity to better understand the value of MII and to isolate the effects of MII from other secular trends in healthcare. The project's analysis will identify the financial implications of deploying MII systems, including the costs and savings attributable to their use. The project will also determine the effect of MII on healthcare quality and safety, by examining process times, efficiency of provider and capital utilization, and management errors. Using data from several smaller and/or rural hospitals, the applicant will develop models to predict the value of MII in different settings. The research will increase the knowledge and understanding of the value of MII and provide data that will facilitate rational decision-making oncerning MM implementation in different heath care settings. The multidisciplinary research team is experienced in all aspects of Medical Imaging Informatics, financial analysis, and technology assessment, and is well qualified to conduct the proposed research. [unreadable] [unreadable]